Healthy Aging and Memory Clinic

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

22610 Issued in IA

Legal business name

HEALTHY AGING AND MEMORY CLINIC

Practice address

1300 50TH Street
Suite 104
West Des Moines, IA 50266

Phone

(515) 224-4100

Fax

(515) 224-4926

NPI assigned

Oct 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert L Bender II, M.D.

Title

Medical Director

Phone

(515) 224-4100

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heidi Louise Close, MD

  • Otolaryngology Physician
  • Pella, IA
  • NPI 1902864903
  NPD (past)
• Daniel Charles Miller, D.O.

  • Family Medicine Physician
  • Clive, IA
  • NPI 1063437812
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1417044645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 106TH STREET",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223766",
            "telephone_number": "515-334-7524",
            "fax_number": "515-334-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 50TH STREET",
            "address_2": "SUITE 104",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "515-224-4100",
            "fax_number": "515-224-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY AGING AND MEMORY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "BENDER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "515-224-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IA",
            "license": "22610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2184259",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healing Paths Intuitive Therapy, PLLC
• Healing Pathways Counseling, LLC
• Healing Roots Therapy, LLC
• Healing Roots Therapy, LLC
• Healing Ways Counseling
• Hearsite, Inc
• Heart and Mind Counseling
• Heart of Gloria Clinical Services, LLC
• Heart of Iowa Midwifery & Birth Services
• Heartland Hospice Services LLC

• All providers in West Des Moines, IA
• Geriatric Medicine (Family Medicine) Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.